Systemic lupus erythematosus history and symptoms: Difference between revisions

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* Symptoms in the below table are listed based on their frequency in each organ system and the disease that is responsible for each symptom:<ref name="pmid14530779">{{cite journal |vauthors=Cervera R, Khamashta MA, Font J, Sebastiani GD, Gil A, Lavilla P, Mejía JC, Aydintug AO, Chwalinska-Sadowska H, de Ramón E, Fernández-Nebro A, Galeazzi M, Valen M, Mathieu A, Houssiau F, Caro N, Alba P, Ramos-Casals M, Ingelmo M, Hughes GR |title=Morbidity and mortality in systemic lupus erythematosus during a 10-year period: a comparison of early and late manifestations in a cohort of 1,000 patients |journal=Medicine (Baltimore) |volume=82 |issue=5 |pages=299–308 |year=2003 |pmid=14530779 |doi=10.1097/01.md.0000091181.93122.55 |url=}}</ref><ref name="pmid2319520">{{cite journal |vauthors=Finol HJ, Montagnani S, Márquez A, Montes de Oca I, Müller B |title=Ultrastructural pathology of skeletal muscle in systemic lupus erythematosus |journal=J. Rheumatol. |volume=17 |issue=2 |pages=210–9 |year=1990 |pmid=2319520 |doi= |url=}}</ref><ref name="pmid20572299">{{cite journal |vauthors=Tian XP, Zhang X |title=Gastrointestinal involvement in systemic lupus erythematosus: insight into pathogenesis, diagnosis and treatment |journal=World J. Gastroenterol. |volume=16 |issue=24 |pages=2971–7 |year=2010 |pmid=20572299 |pmc=2890936 |doi= |url=}}</ref><ref name="pmid27329649">{{cite journal |vauthors=Alves SC, Fasano S, Isenberg DA |title=Autoimmune gastrointestinal complications in patients with systemic lupus erythematosus: case series and literature review |journal=Lupus |volume=25 |issue=14 |pages=1509–1519 |year=2016 |pmid=27329649 |doi=10.1177/0961203316655210 |url=}}</ref><ref name="pmid27055518">{{cite journal |vauthors=Fawzy M, Edrees A, Okasha H, El Ashmaui A, Ragab G |title=Gastrointestinal manifestations in systemic lupus erythematosus |journal=Lupus |volume=25 |issue=13 |pages=1456–1462 |year=2016 |pmid=27055518 |doi=10.1177/0961203316642308 |url=}}</ref><ref name="pmid28523968">{{cite journal |vauthors=Li Z, Xu D, Wang Z, Wang Y, Zhang S, Li M, Zeng X |title=Gastrointestinal system involvement in systemic lupus erythematosus |journal=Lupus |volume= |issue= |pages=961203317707825 |year=2017 |pmid=28523968 |doi=10.1177/0961203317707825 |url=}}</ref><ref name="pmid26550810">{{cite journal |vauthors=Salvati F |title=[The involvement of pulmonary interstitial tissue in multisystemic lupus erythematosus: interdisciplinarity and role of the pneumologists] |language=Italian |journal=Clin Ter |volume=166 |issue=5 |pages=205–7 |year=2015 |pmid=26550810 |doi= |url=}}</ref><ref name="pmid21194884">{{cite journal |vauthors=Torre O, Harari S |title=Pleural and pulmonary involvement in systemic lupus erythematosus |journal=Presse Med |volume=40 |issue=1 Pt 2 |pages=e19–29 |year=2011 |pmid=21194884 |doi=10.1016/j.lpm.2010.11.004 |url=}}</ref><ref name="pmid25639532">{{cite journal |vauthors=Alamoudi OS, Attar SM |title=Pulmonary manifestations in systemic lupus erythematosus: association with disease activity |journal=Respirology |volume=20 |issue=3 |pages=474–80 |year=2015 |pmid=25639532 |pmc=4418345 |doi=10.1111/resp.12473 |url=}}</ref><ref name="pmid25458514">{{cite journal |vauthors=Finucci Curi P, Pierrestegui M, Ortiz A, Ceccato F, Paira S |title=[Pulmonary hemorrhage in patients with systemic lupus erythematosus. Clinical manifestations and prognosis] |language=Spanish; Castilian |journal=Med Clin (Barc) |volume=145 |issue=9 |pages=375–9 |year=2015 |pmid=25458514 |doi=10.1016/j.medcli.2014.07.034 |url=}}</ref><ref name="pmid24790989">{{cite journal |vauthors=Mak A, Kow NY |title=Imbalance between endothelial damage and repair: a gateway to cardiovascular disease in systemic lupus erythematosus |journal=Biomed Res Int |volume=2014 |issue= |pages=178721 |year=2014 |pmid=24790989 |pmc=3984775 |doi=10.1155/2014/178721 |url=}}</ref><ref name="pmid24722263">{{cite journal |vauthors=Sacre K, Escoubet B, Pasquet B, Chauveheid MP, Zennaro MC, Tubach F, Papo T |title=Increased arterial stiffness in systemic lupus erythematosus (SLE) patients at low risk for cardiovascular disease: a cross-sectional controlled study |journal=PLoS ONE |volume=9 |issue=4 |pages=e94511 |year=2014 |pmid=24722263 |pmc=3983200 |doi=10.1371/journal.pone.0094511 |url=}}</ref><ref name="pmid23052654">{{cite journal |vauthors=Canpolat N, Kasapcopur O, Caliskan S, Gokalp S, Bor M, Tasdemir M, Sever L, Arisoy N |title=Ambulatory blood pressure and subclinical cardiovascular disease in patients with juvenile-onset systemic lupus erythematosus |journal=Pediatr. Nephrol. |volume=28 |issue=2 |pages=305–13 |year=2013 |pmid=23052654 |doi=10.1007/s00467-012-2317-3 |url=}}</ref><ref name="pmid19366083">{{cite journal |vauthors=Cojocaru IM, Cojocaru M, Tănăsescu R, Burcin C, Atanasiu AN, Silosi I |title=Detection of autoantibodies to ribosome P in lupus patients with neurological involvement |journal=Rom J Intern Med |volume=46 |issue=3 |pages=239–42 |year=2008 |pmid=19366083 |doi= |url=}}</ref><ref name="pmid22594009">{{cite journal |vauthors=Madrane S, Ribi C |title=[Central neuropsychiatric involvement in systemic lupus erythematosus] |language=French |journal=Rev Med Suisse |volume=8 |issue=337 |pages=848–53 |year=2012 |pmid=22594009 |doi= |url=}}</ref><ref name="pmid7555923">{{cite journal |vauthors=Sivri A, Hasçelik Z, Celiker R, Başgöze O |title=Early detection of neurological involvement in systemic lupus erythematosus patients |journal=Electromyogr Clin Neurophysiol |volume=35 |issue=4 |pages=195–9 |year=1995 |pmid=7555923 |doi= |url=}}</ref><ref name="pmid19217587">{{cite journal |vauthors=Juncal Gallego L, Almuíña Simón C, Muíños Esparza LF, Díaz Soto R, Ramil Fraga C, Quiroga Ordóñez E |title=[Systemic lupus erythematosus with fulminant neurological involvement] |language=Spanish; Castilian |journal=An Pediatr (Barc) |volume=70 |issue=2 |pages=202–4 |year=2009 |pmid=19217587 |doi=10.1016/j.anpedi.2008.09.009 |url=}}</ref><ref name="pmid22192934">{{cite journal |vauthors=Karras A |title=[Renal involvement in systemic lupus erythematosus] |language=French |journal=Presse Med |volume=41 |issue=3 Pt 1 |pages=260–6 |year=2012 |pmid=22192934 |doi=10.1016/j.lpm.2011.11.006 |url=}}</ref><ref name="pmid25548784">{{cite journal |vauthors=Kiremitci S, Ensari A |title=Classifying lupus nephritis: an ongoing story |journal=ScientificWorldJournal |volume=2014 |issue= |pages=580620 |year=2014 |pmid=25548784 |pmc=4274910 |doi=10.1155/2014/580620 |url=}}</ref><ref name="pmid15580980">{{cite journal |vauthors=Zoma A |title=Musculoskeletal involvement in systemic lupus erythematosus |journal=Lupus |volume=13 |issue=11 |pages=851–3 |year=2004 |pmid=15580980 |doi=10.1191/0961203303lu2021oa |url=}}</ref><ref name="pmid22956550">{{cite journal |vauthors=Gabba A, Piga M, Vacca A, Porru G, Garau P, Cauli A, Mathieu A |title=Joint and tendon involvement in systemic lupus erythematosus: an ultrasound study of hands and wrists in 108 patients |journal=Rheumatology (Oxford) |volume=51 |issue=12 |pages=2278–85 |year=2012 |pmid=22956550 |doi=10.1093/rheumatology/kes226 |url=}}</ref><ref name="pmid19591780">{{cite journal |vauthors=Grossman JM |title=Lupus arthritis |journal=Best Pract Res Clin Rheumatol |volume=23 |issue=4 |pages=495–506 |year=2009 |pmid=19591780 |doi=10.1016/j.berh.2009.04.003 |url=}}</ref><ref name="pmid24862229">{{cite journal |vauthors=Zhu KK, Xu WD, Pan HF, Zhang M, Ni J, Ge FY, Ye DQ |title=The risk factors of avascular necrosis in patients with systemic lupus erythematosus: a meta-analysis |journal=Inflammation |volume=37 |issue=5 |pages=1852–64 |year=2014 |pmid=24862229 |doi=10.1007/s10753-014-9917-y |url=}}</ref><ref name="pmid23731640">{{cite journal |vauthors=Voulgari PV, Kosta P, Argyropoulou MI, Drosos AA |title=Avascular necrosis in a patient with systemic lupus erythematosus |journal=Joint Bone Spine |volume=80 |issue=6 |pages=665 |year=2013 |pmid=23731640 |doi=10.1016/j.jbspin.2013.03.018 |url=}}</ref><ref name="pmid25077888">{{cite journal |vauthors=Parodi A, Cozzani E |title=Cutaneous manifestations of lupus erythematosus |journal=G Ital Dermatol Venereol |volume=149 |issue=5 |pages=549–54 |year=2014 |pmid=25077888 |doi= |url=}}</ref><ref name="pmid26985173">{{cite journal |vauthors=Szczęch J, Rutka M, Samotij D, Zalewska A, Reich A |title=Clinical characteristics of cutaneous lupus erythematosus |journal=Postepy Dermatol Alergol |volume=33 |issue=1 |pages=13–7 |year=2016 |pmid=26985173 |pmc=4793050 |doi=10.5114/pdia.2014.44031 |url=}}</ref><ref name="pmid19824738">{{cite journal |vauthors=Walling HW, Sontheimer RD |title=Cutaneous lupus erythematosus: issues in diagnosis and treatment |journal=Am J Clin Dermatol |volume=10 |issue=6 |pages=365–81 |year=2009 |pmid=19824738 |doi=10.2165/11310780-000000000-00000 |url=}}</ref>
* Symptoms in the below table are listed based on their frequency in each organ system and the disease that is responsible for each symptom:<ref name="pmid14530779">{{cite journal |vauthors=Cervera R, Khamashta MA, Font J, Sebastiani GD, Gil A, Lavilla P, Mejía JC, Aydintug AO, Chwalinska-Sadowska H, de Ramón E, Fernández-Nebro A, Galeazzi M, Valen M, Mathieu A, Houssiau F, Caro N, Alba P, Ramos-Casals M, Ingelmo M, Hughes GR |title=Morbidity and mortality in systemic lupus erythematosus during a 10-year period: a comparison of early and late manifestations in a cohort of 1,000 patients |journal=Medicine (Baltimore) |volume=82 |issue=5 |pages=299–308 |year=2003 |pmid=14530779 |doi=10.1097/01.md.0000091181.93122.55 |url=}}</ref><ref name="pmid2319520">{{cite journal |vauthors=Finol HJ, Montagnani S, Márquez A, Montes de Oca I, Müller B |title=Ultrastructural pathology of skeletal muscle in systemic lupus erythematosus |journal=J. Rheumatol. |volume=17 |issue=2 |pages=210–9 |year=1990 |pmid=2319520 |doi= |url=}}</ref><ref name="pmid20572299">{{cite journal |vauthors=Tian XP, Zhang X |title=Gastrointestinal involvement in systemic lupus erythematosus: insight into pathogenesis, diagnosis and treatment |journal=World J. Gastroenterol. |volume=16 |issue=24 |pages=2971–7 |year=2010 |pmid=20572299 |pmc=2890936 |doi= |url=}}</ref><ref name="pmid27329649">{{cite journal |vauthors=Alves SC, Fasano S, Isenberg DA |title=Autoimmune gastrointestinal complications in patients with systemic lupus erythematosus: case series and literature review |journal=Lupus |volume=25 |issue=14 |pages=1509–1519 |year=2016 |pmid=27329649 |doi=10.1177/0961203316655210 |url=}}</ref><ref name="pmid27055518">{{cite journal |vauthors=Fawzy M, Edrees A, Okasha H, El Ashmaui A, Ragab G |title=Gastrointestinal manifestations in systemic lupus erythematosus |journal=Lupus |volume=25 |issue=13 |pages=1456–1462 |year=2016 |pmid=27055518 |doi=10.1177/0961203316642308 |url=}}</ref><ref name="pmid28523968">{{cite journal |vauthors=Li Z, Xu D, Wang Z, Wang Y, Zhang S, Li M, Zeng X |title=Gastrointestinal system involvement in systemic lupus erythematosus |journal=Lupus |volume= |issue= |pages=961203317707825 |year=2017 |pmid=28523968 |doi=10.1177/0961203317707825 |url=}}</ref><ref name="pmid26550810">{{cite journal |vauthors=Salvati F |title=[The involvement of pulmonary interstitial tissue in multisystemic lupus erythematosus: interdisciplinarity and role of the pneumologists] |language=Italian |journal=Clin Ter |volume=166 |issue=5 |pages=205–7 |year=2015 |pmid=26550810 |doi= |url=}}</ref><ref name="pmid21194884">{{cite journal |vauthors=Torre O, Harari S |title=Pleural and pulmonary involvement in systemic lupus erythematosus |journal=Presse Med |volume=40 |issue=1 Pt 2 |pages=e19–29 |year=2011 |pmid=21194884 |doi=10.1016/j.lpm.2010.11.004 |url=}}</ref><ref name="pmid25639532">{{cite journal |vauthors=Alamoudi OS, Attar SM |title=Pulmonary manifestations in systemic lupus erythematosus: association with disease activity |journal=Respirology |volume=20 |issue=3 |pages=474–80 |year=2015 |pmid=25639532 |pmc=4418345 |doi=10.1111/resp.12473 |url=}}</ref><ref name="pmid25458514">{{cite journal |vauthors=Finucci Curi P, Pierrestegui M, Ortiz A, Ceccato F, Paira S |title=[Pulmonary hemorrhage in patients with systemic lupus erythematosus. Clinical manifestations and prognosis] |language=Spanish; Castilian |journal=Med Clin (Barc) |volume=145 |issue=9 |pages=375–9 |year=2015 |pmid=25458514 |doi=10.1016/j.medcli.2014.07.034 |url=}}</ref><ref name="pmid24790989">{{cite journal |vauthors=Mak A, Kow NY |title=Imbalance between endothelial damage and repair: a gateway to cardiovascular disease in systemic lupus erythematosus |journal=Biomed Res Int |volume=2014 |issue= |pages=178721 |year=2014 |pmid=24790989 |pmc=3984775 |doi=10.1155/2014/178721 |url=}}</ref><ref name="pmid24722263">{{cite journal |vauthors=Sacre K, Escoubet B, Pasquet B, Chauveheid MP, Zennaro MC, Tubach F, Papo T |title=Increased arterial stiffness in systemic lupus erythematosus (SLE) patients at low risk for cardiovascular disease: a cross-sectional controlled study |journal=PLoS ONE |volume=9 |issue=4 |pages=e94511 |year=2014 |pmid=24722263 |pmc=3983200 |doi=10.1371/journal.pone.0094511 |url=}}</ref><ref name="pmid23052654">{{cite journal |vauthors=Canpolat N, Kasapcopur O, Caliskan S, Gokalp S, Bor M, Tasdemir M, Sever L, Arisoy N |title=Ambulatory blood pressure and subclinical cardiovascular disease in patients with juvenile-onset systemic lupus erythematosus |journal=Pediatr. Nephrol. |volume=28 |issue=2 |pages=305–13 |year=2013 |pmid=23052654 |doi=10.1007/s00467-012-2317-3 |url=}}</ref><ref name="pmid19366083">{{cite journal |vauthors=Cojocaru IM, Cojocaru M, Tănăsescu R, Burcin C, Atanasiu AN, Silosi I |title=Detection of autoantibodies to ribosome P in lupus patients with neurological involvement |journal=Rom J Intern Med |volume=46 |issue=3 |pages=239–42 |year=2008 |pmid=19366083 |doi= |url=}}</ref><ref name="pmid22594009">{{cite journal |vauthors=Madrane S, Ribi C |title=[Central neuropsychiatric involvement in systemic lupus erythematosus] |language=French |journal=Rev Med Suisse |volume=8 |issue=337 |pages=848–53 |year=2012 |pmid=22594009 |doi= |url=}}</ref><ref name="pmid7555923">{{cite journal |vauthors=Sivri A, Hasçelik Z, Celiker R, Başgöze O |title=Early detection of neurological involvement in systemic lupus erythematosus patients |journal=Electromyogr Clin Neurophysiol |volume=35 |issue=4 |pages=195–9 |year=1995 |pmid=7555923 |doi= |url=}}</ref><ref name="pmid19217587">{{cite journal |vauthors=Juncal Gallego L, Almuíña Simón C, Muíños Esparza LF, Díaz Soto R, Ramil Fraga C, Quiroga Ordóñez E |title=[Systemic lupus erythematosus with fulminant neurological involvement] |language=Spanish; Castilian |journal=An Pediatr (Barc) |volume=70 |issue=2 |pages=202–4 |year=2009 |pmid=19217587 |doi=10.1016/j.anpedi.2008.09.009 |url=}}</ref><ref name="pmid22192934">{{cite journal |vauthors=Karras A |title=[Renal involvement in systemic lupus erythematosus] |language=French |journal=Presse Med |volume=41 |issue=3 Pt 1 |pages=260–6 |year=2012 |pmid=22192934 |doi=10.1016/j.lpm.2011.11.006 |url=}}</ref><ref name="pmid25548784">{{cite journal |vauthors=Kiremitci S, Ensari A |title=Classifying lupus nephritis: an ongoing story |journal=ScientificWorldJournal |volume=2014 |issue= |pages=580620 |year=2014 |pmid=25548784 |pmc=4274910 |doi=10.1155/2014/580620 |url=}}</ref><ref name="pmid15580980">{{cite journal |vauthors=Zoma A |title=Musculoskeletal involvement in systemic lupus erythematosus |journal=Lupus |volume=13 |issue=11 |pages=851–3 |year=2004 |pmid=15580980 |doi=10.1191/0961203303lu2021oa |url=}}</ref><ref name="pmid22956550">{{cite journal |vauthors=Gabba A, Piga M, Vacca A, Porru G, Garau P, Cauli A, Mathieu A |title=Joint and tendon involvement in systemic lupus erythematosus: an ultrasound study of hands and wrists in 108 patients |journal=Rheumatology (Oxford) |volume=51 |issue=12 |pages=2278–85 |year=2012 |pmid=22956550 |doi=10.1093/rheumatology/kes226 |url=}}</ref><ref name="pmid19591780">{{cite journal |vauthors=Grossman JM |title=Lupus arthritis |journal=Best Pract Res Clin Rheumatol |volume=23 |issue=4 |pages=495–506 |year=2009 |pmid=19591780 |doi=10.1016/j.berh.2009.04.003 |url=}}</ref><ref name="pmid24862229">{{cite journal |vauthors=Zhu KK, Xu WD, Pan HF, Zhang M, Ni J, Ge FY, Ye DQ |title=The risk factors of avascular necrosis in patients with systemic lupus erythematosus: a meta-analysis |journal=Inflammation |volume=37 |issue=5 |pages=1852–64 |year=2014 |pmid=24862229 |doi=10.1007/s10753-014-9917-y |url=}}</ref><ref name="pmid23731640">{{cite journal |vauthors=Voulgari PV, Kosta P, Argyropoulou MI, Drosos AA |title=Avascular necrosis in a patient with systemic lupus erythematosus |journal=Joint Bone Spine |volume=80 |issue=6 |pages=665 |year=2013 |pmid=23731640 |doi=10.1016/j.jbspin.2013.03.018 |url=}}</ref><ref name="pmid25077888">{{cite journal |vauthors=Parodi A, Cozzani E |title=Cutaneous manifestations of lupus erythematosus |journal=G Ital Dermatol Venereol |volume=149 |issue=5 |pages=549–54 |year=2014 |pmid=25077888 |doi= |url=}}</ref><ref name="pmid26985173">{{cite journal |vauthors=Szczęch J, Rutka M, Samotij D, Zalewska A, Reich A |title=Clinical characteristics of cutaneous lupus erythematosus |journal=Postepy Dermatol Alergol |volume=33 |issue=1 |pages=13–7 |year=2016 |pmid=26985173 |pmc=4793050 |doi=10.5114/pdia.2014.44031 |url=}}</ref><ref name="pmid19824738">{{cite journal |vauthors=Walling HW, Sontheimer RD |title=Cutaneous lupus erythematosus: issues in diagnosis and treatment |journal=Am J Clin Dermatol |volume=10 |issue=6 |pages=365–81 |year=2009 |pmid=19824738 |doi=10.2165/11310780-000000000-00000 |url=}}</ref>
{| class="wikitable"
{| class="wikitable"
!Organ system
! style="background: #4479BA; color: #FFFFFF; " |Organ system
!Disease
! style="background: #4479BA; color: #FFFFFF; " |Disease
!Sympton
! style="background: #4479BA; color: #FFFFFF; " |Symptom
|-
|-
| rowspan="7" |[[Gastrointestinal]]
| rowspan="7" |[[Gastrointestinal]]
|[[Dysphagia]] 
| style="background: #DCDCDC; " |[[Dysphagia]] 
|
|
* Retrosternal [[chest pain]]
* Retrosternal [[chest pain]]
Line 59: Line 59:
* [[Odynophagia]]
* [[Odynophagia]]
|-
|-
|[[Peptic ulcer disease]]
| style="background: #DCDCDC; " |[[Peptic ulcer disease]]
|
|
* [[Epigastric pain]]
* [[Epigastric pain]]
Line 66: Line 66:
* [[Nausea]]
* [[Nausea]]
|-
|-
|[[Intestinal pseudoobstruction|Intestinal pseudo-obstruction]]
| style="background: #DCDCDC; " |[[Intestinal pseudoobstruction|Intestinal pseudo-obstruction]]
|
|
* [[Abdominal pain]]
* [[Abdominal pain]]
Line 72: Line 72:
* [[Distension]]
* [[Distension]]
|-
|-
|[[Protein losing enteropathy|Protein-losing enteropathy]]
| style="background: #DCDCDC; " |[[Protein losing enteropathy|Protein-losing enteropathy]]
|
|
* Profound [[edema]]
* Profound [[edema]]
* Severe [[diarrhea]]
* Severe [[diarrhea]]
|-
|-
|[[Acute pancreatitis]]
| style="background: #DCDCDC; " |[[Acute pancreatitis]]
|
|
* Severe persistent [[epigastric pain]] often radiating to the back
* Severe persistent [[epigastric pain]] often radiating to the back
|-
|-
|[[Vasculitis|Mesenteric vasculitis]]
| style="background: #DCDCDC; " |[[Vasculitis|Mesenteric vasculitis]]
|
|
* [[Abdominal pain]]
* [[Abdominal pain]]
Line 91: Line 91:
** Due to chronic [[mesenteric ischemia]]
** Due to chronic [[mesenteric ischemia]]
|-
|-
|[[Peritonitis]]
| style="background: #DCDCDC; " |[[Peritonitis]]
|
|
* Abdominal [[bloating]] or [[Abdominal distension|distension]]
* Abdominal [[bloating]] or [[Abdominal distension|distension]]
Line 100: Line 100:
|-
|-
| rowspan="7" |[[Pulmonary]]
| rowspan="7" |[[Pulmonary]]
|[[Pleural disease]]
| style="background: #DCDCDC; " |[[Pleural disease]]
|
|
* [[Cough]]
* [[Cough]]
Line 106: Line 106:
* [[Fever]]
* [[Fever]]
|-
|-
|[[Pneumonitis]]
| style="background: #DCDCDC; " |[[Pneumonitis]]
|
|
* [[Fever]]
* [[Fever]]
Line 112: Line 112:
* [[Dyspnea]]
* [[Dyspnea]]
|-
|-
|[[Pulmonary hemorrhage]]
| style="background: #DCDCDC; " |[[Pulmonary hemorrhage]]
|
|
* [[Dyspnea]]
* [[Dyspnea]]
Line 118: Line 118:
* [[Hemoptysis]]
* [[Hemoptysis]]
|-
|-
|[[Interstitial lung disease]]
| style="background: #DCDCDC; " |[[Interstitial lung disease]]
|
|
* May be asymptomatic
* May be asymptomatic
Line 125: Line 125:
* Decreased [[Exercise tolerance test|exercise tolerance]]
* Decreased [[Exercise tolerance test|exercise tolerance]]
|-
|-
|[[Pulmonary emboli]] 
| style="background: #DCDCDC; " |[[Pulmonary emboli]] 
|
|
* [[Dyspnea]]
* [[Dyspnea]]
* Sharp [[chest pain]] that may become worse with deep breathing or [[Cough|coughing]]
* Sharp [[chest pain]] that may become worse with deep breathing or [[Cough|coughing]]
|-
|-
|[[Pulmonary hypertension]]
| style="background: #DCDCDC; " |[[Pulmonary hypertension]]
|
|
* [[Dyspnea]]
* [[Dyspnea]]
Line 141: Line 141:
* Increased abdominal girth
* Increased abdominal girth
|-
|-
|Shrinking lung syndrome
| style="background: #DCDCDC; " |Shrinking lung syndrome
|
|
* [[Dyspnea]]
* [[Dyspnea]]
* [[Pleuritic chest pain]] (episodic)
* [[Pleuritic chest pain]] (episodic)
|-
|-
| rowspan="4" |[[Cardiac]]
| rowspan="4" |<small>[[Cardiac]]</small>
|[[Valvular disease]]
| style="background: #DCDCDC; " |[[Valvular disease]]
|
|
* [[Tachycardia]]
* [[Tachycardia]]
Line 154: Line 154:
* [[Peripheral edema]]
* [[Peripheral edema]]
|-
|-
|[[Pericarditis]]
| style="background: #DCDCDC; " |[[Pericarditis]]
|
|
* Sharp, stabbing [[chest pain]] with a sudden start
* Sharp, stabbing [[chest pain]] with a sudden start
* Positional pain that decreases when sitting up and leaning forward
* Positional pain that decreases when sitting up and leaning forward
|-
|-
|[[Myocarditis]] 
| style="background: #DCDCDC; " |[[Myocarditis]] 
|
|
* [[Tachycardia]]
* [[Tachycardia]]
* [[Fever]] and chills
* [[Fever]] and chills
|-
|-
|[[Coronary heart disease]]
| style="background: #DCDCDC; " |[[Coronary heart disease]]
|
|
* [[Chest pain]]
* [[Chest pain]]
Line 170: Line 170:
* [[Nausea and vomiting]]
* [[Nausea and vomiting]]
|-
|-
| rowspan="4" |[[Neurological disorders|Neurological]]
| rowspan="4" |<small>[[Neurological disorders|Neurological]]</small>
|CNS small vessle [[vasculitis]]
| style="background: #DCDCDC; " |CNS small vessle [[vasculitis]]
|
|
* [[Cognitive impairment]]
* [[Cognitive impairment]]
* [[Headache]]
* [[Headache]]
|-
|-
|[[Stroke]]
| style="background: #DCDCDC; " |[[Stroke]]
|
|
* [[Speech disturbances|Speech disturbance]]
* [[Speech disturbances|Speech disturbance]]
* [[Weakness]] on one-half of the body
* [[Weakness]] on one-half of the body
|-
|-
|[[Seizure|Seizures]]
| style="background: #DCDCDC; " |[[Seizure|Seizures]]
|
|
* [[Tonic-clonic seizure]]
* [[Tonic-clonic seizure]]
|-
|-
|[[Psychosis]]
| style="background: #DCDCDC; " |[[Psychosis]]
|
|
* [[Hallucination|Hallucinations]]
* [[Hallucination|Hallucinations]]
Line 191: Line 191:
** [[Auditory hallucinations|Auditory]]
** [[Auditory hallucinations|Auditory]]
|-
|-
|[[Genitourinary system|Genitourinary]]
|<small>[[Genitourinary system|Genitourinary]]</small>
|[[Nephrotic syndrome]]
| style="background: #DCDCDC; " |[[Nephrotic syndrome]]
|
|
* [[Hypertension]]
* [[Hypertension]]
Line 199: Line 199:
* [[Weight gain]]
* [[Weight gain]]
|-
|-
| rowspan="3" |[[Musculoskeletal]]
| rowspan="3" |<small>[[Musculoskeletal]]</small>
|[[Arthritis]]
| style="background: #DCDCDC; " |[[Arthritis]]
|
|
* Mostly symmetrical
* Mostly symmetrical
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* Morning stiffness that will last less than 1 hour
* Morning stiffness that will last less than 1 hour
|-
|-
|[[Avascular necrosis]]
| style="background: #DCDCDC; " |[[Avascular necrosis]]
|
|
* Asymptomatic
* Asymptomatic
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* Secondary pain amplification
* Secondary pain amplification
|-
|-
|[[Osteoporosis]] 
| style="background: #DCDCDC; " |[[Osteoporosis]] 
|
|
* Loss of height
* Loss of height
* Sudden [[back pain]]
* Sudden [[back pain]]
|-
|-
| rowspan="4" |[[Skin]] disorder
| rowspan="4" |<small>[[Skin]] disorder</small>
|[[Cutaneous lupus erythematosus]]
| style="background: #DCDCDC; " |[[Cutaneous lupus erythematosus]]
|
|
* [[Malar rash]]
* [[Malar rash]]
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* Nail fold infarcts
* Nail fold infarcts
|-
|-
|[[Photosensitivity]]
| style="background: #DCDCDC; " |[[Photosensitivity]]
|
|
* Common theme for skin [[lesions]] associated with [[SLE]]
* Common theme for skin [[lesions]] associated with [[SLE]]
|-
|-
|[[Oral ulcer|Oral]] and nasal ulcers
| style="background: #DCDCDC; " |[[Oral ulcer|Oral]] and nasal ulcers
|
|
* Usually painless
* Usually painless
|-
|-
|[[Alopecia|Nonscarring alopecia]]
| style="background: #DCDCDC; " |[[Alopecia|Nonscarring alopecia]]
|
|
* May occur at some point during the course of their disease
* May occur at some point during the course of their disease

Revision as of 21:05, 31 July 2017

Systemic lupus erythematosus Microchapters

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Raviteja Guddeti, M.B.B.S. [2]

Overview

A positive history of familial lupus, skin rashes (especially photosensitive skin rashes), arthritis, and fatigue may be suggestive of systemic lupus erythematosus. The most common symptoms of SLE include constituitional symptoms like Fatigue, Fever, Myalgia, and weight changes. Other organ specific symptoms mostly occur with disease progression. SLE may show a variety of symptoms in different organs according to its complications.

History

Obtaining the history is one of the most important aspects in making a diagnosis of systemic lupus erythematosus. It provides insight into disease course and severity, precipitating risk factors and associated comorbid conditions. Complete history will help determine the correct complication diagnosis, and helps in determining the prognosis as well. Specific histories about the symptoms (duration, onset, progression), associated symptoms, and drug usage have to be obtained. Specific areas of focus when obtaining the history, are outlined below:

Common Symptoms

The early manifestations of systemic lupus erythematosus include common constitutional symptoms that may be seen in many other diseases as well:[1][2][3]

Less Common Symptoms

Organ system based signs and symptoms

Organ system Disease Symptom
Gastrointestinal Dysphagia 
Peptic ulcer disease
Intestinal pseudo-obstruction
Protein-losing enteropathy
Acute pancreatitis
Mesenteric vasculitis
Peritonitis
Pulmonary Pleural disease
Pneumonitis
Pulmonary hemorrhage
Interstitial lung disease
Pulmonary emboli 
Pulmonary hypertension
Shrinking lung syndrome
Cardiac Valvular disease
Pericarditis
  • Sharp, stabbing chest pain with a sudden start
  • Positional pain that decreases when sitting up and leaning forward
Myocarditis 
Coronary heart disease
Neurological CNS small vessle vasculitis
Stroke
Seizures
Psychosis
Genitourinary Nephrotic syndrome
Musculoskeletal Arthritis
  • Mostly symmetrical
  • Arthralgias
  • Decreased range of motion of both small and large joints
  • Morning stiffness that will last less than 1 hour
Avascular necrosis
  • Asymptomatic
  • Mild to moderate pain in groin and lower abdomen in case of femoral head AVN
  • Secondary pain amplification
Osteoporosis 
Skin disorder Cutaneous lupus erythematosus
Photosensitivity
Oral and nasal ulcers
  • Usually painless
Nonscarring alopecia
  • May occur at some point during the course of their disease

References

  1. ↑ Tench CM, McCurdie I, White PD, D'Cruz DP (2000). "The prevalence and associations of fatigue in systemic lupus erythematosus". Rheumatology (Oxford). 39 (11): 1249–54. PMID 11085805.
  2. ↑ McKinley PS, Ouellette SC, Winkel GH (1995). "The contributions of disease activity, sleep patterns, and depression to fatigue in systemic lupus erythematosus. A proposed model". Arthritis Rheum. 38 (6): 826–34. PMID 7779127.
  3. ↑ Wang B, Gladman DD, Urowitz MB (1998). "Fatigue in lupus is not correlated with disease activity". J. Rheumatol. 25 (5): 892–5. PMID 9598886.
  4. ↑ Cervera R, Khamashta MA, Font J, Sebastiani GD, Gil A, Lavilla P, Mejía JC, Aydintug AO, Chwalinska-Sadowska H, de Ramón E, Fernández-Nebro A, Galeazzi M, Valen M, Mathieu A, Houssiau F, Caro N, Alba P, Ramos-Casals M, Ingelmo M, Hughes GR (2003). "Morbidity and mortality in systemic lupus erythematosus during a 10-year period: a comparison of early and late manifestations in a cohort of 1,000 patients". Medicine (Baltimore). 82 (5): 299–308. doi:10.1097/01.md.0000091181.93122.55. PMID 14530779.
  5. ↑ Finol HJ, Montagnani S, Márquez A, Montes de Oca I, Müller B (1990). "Ultrastructural pathology of skeletal muscle in systemic lupus erythematosus". J. Rheumatol. 17 (2): 210–9. PMID 2319520.
  6. ↑ Tian XP, Zhang X (2010). "Gastrointestinal involvement in systemic lupus erythematosus: insight into pathogenesis, diagnosis and treatment". World J. Gastroenterol. 16 (24): 2971–7. PMC 2890936. PMID 20572299.
  7. ↑ Alves SC, Fasano S, Isenberg DA (2016). "Autoimmune gastrointestinal complications in patients with systemic lupus erythematosus: case series and literature review". Lupus. 25 (14): 1509–1519. doi:10.1177/0961203316655210. PMID 27329649.
  8. ↑ Fawzy M, Edrees A, Okasha H, El Ashmaui A, Ragab G (2016). "Gastrointestinal manifestations in systemic lupus erythematosus". Lupus. 25 (13): 1456–1462. doi:10.1177/0961203316642308. PMID 27055518.
  9. ↑ Li Z, Xu D, Wang Z, Wang Y, Zhang S, Li M, Zeng X (2017). "Gastrointestinal system involvement in systemic lupus erythematosus". Lupus: 961203317707825. doi:10.1177/0961203317707825. PMID 28523968.
  10. ↑ Salvati F (2015). "[The involvement of pulmonary interstitial tissue in multisystemic lupus erythematosus: interdisciplinarity and role of the pneumologists]". Clin Ter (in Italian). 166 (5): 205–7. PMID 26550810.
  11. ↑ Torre O, Harari S (2011). "Pleural and pulmonary involvement in systemic lupus erythematosus". Presse Med. 40 (1 Pt 2): e19–29. doi:10.1016/j.lpm.2010.11.004. PMID 21194884.
  12. ↑ Alamoudi OS, Attar SM (2015). "Pulmonary manifestations in systemic lupus erythematosus: association with disease activity". Respirology. 20 (3): 474–80. doi:10.1111/resp.12473. PMC 4418345. PMID 25639532.
  13. ↑ Finucci Curi P, Pierrestegui M, Ortiz A, Ceccato F, Paira S (2015). "[Pulmonary hemorrhage in patients with systemic lupus erythematosus. Clinical manifestations and prognosis]". Med Clin (Barc) (in Spanish; Castilian). 145 (9): 375–9. doi:10.1016/j.medcli.2014.07.034. PMID 25458514.
  14. ↑ Mak A, Kow NY (2014). "Imbalance between endothelial damage and repair: a gateway to cardiovascular disease in systemic lupus erythematosus". Biomed Res Int. 2014: 178721. doi:10.1155/2014/178721. PMC 3984775. PMID 24790989.
  15. ↑ Sacre K, Escoubet B, Pasquet B, Chauveheid MP, Zennaro MC, Tubach F, Papo T (2014). "Increased arterial stiffness in systemic lupus erythematosus (SLE) patients at low risk for cardiovascular disease: a cross-sectional controlled study". PLoS ONE. 9 (4): e94511. doi:10.1371/journal.pone.0094511. PMC 3983200. PMID 24722263.
  16. ↑ Canpolat N, Kasapcopur O, Caliskan S, Gokalp S, Bor M, Tasdemir M, Sever L, Arisoy N (2013). "Ambulatory blood pressure and subclinical cardiovascular disease in patients with juvenile-onset systemic lupus erythematosus". Pediatr. Nephrol. 28 (2): 305–13. doi:10.1007/s00467-012-2317-3. PMID 23052654.
  17. ↑ Cojocaru IM, Cojocaru M, Tănăsescu R, Burcin C, Atanasiu AN, Silosi I (2008). "Detection of autoantibodies to ribosome P in lupus patients with neurological involvement". Rom J Intern Med. 46 (3): 239–42. PMID 19366083.
  18. ↑ Madrane S, Ribi C (2012). "[Central neuropsychiatric involvement in systemic lupus erythematosus]". Rev Med Suisse (in French). 8 (337): 848–53. PMID 22594009.
  19. ↑ Sivri A, Hasçelik Z, Celiker R, Başgöze O (1995). "Early detection of neurological involvement in systemic lupus erythematosus patients". Electromyogr Clin Neurophysiol. 35 (4): 195–9. PMID 7555923.
  20. ↑ Juncal Gallego L, Almuíña Simón C, Muíños Esparza LF, Díaz Soto R, Ramil Fraga C, Quiroga Ordóñez E (2009). "[Systemic lupus erythematosus with fulminant neurological involvement]". An Pediatr (Barc) (in Spanish; Castilian). 70 (2): 202–4. doi:10.1016/j.anpedi.2008.09.009. PMID 19217587.
  21. ↑ Karras A (2012). "[Renal involvement in systemic lupus erythematosus]". Presse Med (in French). 41 (3 Pt 1): 260–6. doi:10.1016/j.lpm.2011.11.006. PMID 22192934.
  22. ↑ Kiremitci S, Ensari A (2014). "Classifying lupus nephritis: an ongoing story". ScientificWorldJournal. 2014: 580620. doi:10.1155/2014/580620. PMC 4274910. PMID 25548784.
  23. ↑ Zoma A (2004). "Musculoskeletal involvement in systemic lupus erythematosus". Lupus. 13 (11): 851–3. doi:10.1191/0961203303lu2021oa. PMID 15580980.
  24. ↑ Gabba A, Piga M, Vacca A, Porru G, Garau P, Cauli A, Mathieu A (2012). "Joint and tendon involvement in systemic lupus erythematosus: an ultrasound study of hands and wrists in 108 patients". Rheumatology (Oxford). 51 (12): 2278–85. doi:10.1093/rheumatology/kes226. PMID 22956550.
  25. ↑ Grossman JM (2009). "Lupus arthritis". Best Pract Res Clin Rheumatol. 23 (4): 495–506. doi:10.1016/j.berh.2009.04.003. PMID 19591780.
  26. ↑ Zhu KK, Xu WD, Pan HF, Zhang M, Ni J, Ge FY, Ye DQ (2014). "The risk factors of avascular necrosis in patients with systemic lupus erythematosus: a meta-analysis". Inflammation. 37 (5): 1852–64. doi:10.1007/s10753-014-9917-y. PMID 24862229.
  27. ↑ Voulgari PV, Kosta P, Argyropoulou MI, Drosos AA (2013). "Avascular necrosis in a patient with systemic lupus erythematosus". Joint Bone Spine. 80 (6): 665. doi:10.1016/j.jbspin.2013.03.018. PMID 23731640.
  28. ↑ Parodi A, Cozzani E (2014). "Cutaneous manifestations of lupus erythematosus". G Ital Dermatol Venereol. 149 (5): 549–54. PMID 25077888.
  29. ↑ Szczęch J, Rutka M, Samotij D, Zalewska A, Reich A (2016). "Clinical characteristics of cutaneous lupus erythematosus". Postepy Dermatol Alergol. 33 (1): 13–7. doi:10.5114/pdia.2014.44031. PMC 4793050. PMID 26985173.
  30. ↑ Walling HW, Sontheimer RD (2009). "Cutaneous lupus erythematosus: issues in diagnosis and treatment". Am J Clin Dermatol. 10 (6): 365–81. doi:10.2165/11310780-000000000-00000. PMID 19824738.

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